Federal prosecutors laid out their opening arguments Monday against a Texas oral surgeon facing 22 federal counts of conspiracy and Medicaid fraud that allegedly yielded him more than $4.5 million in fraudulent billings.

Gary Morgan Schwarz, DDS, of McAllen, Texas, (a town made infamous for its high healthcare costs in a 2009 New Yorker article) is accused of conspiring with his employees and area dentists, who were later removed from the indictment, to defraud Medicaid for an estimated $4.6 million between January 2007 and April 2010.

The June 2010 indictment alleges that he "submitted claims to Medicaid for payment for services not performed, examinations not performed by him personally, for services provided by unqualified persons including the administration of anesthesia and for Medicare beneficiaries unlawfully referred to him."

The U.S. Attorney's Office used video shot by an informant to build its case against Dr. Schwarz. The video reportedly shows the surgeon removing wisdom teeth from several children in less than 20 minutes and sending them out of the office, still feeling the effects of anesthesia, shortly thereafter. U.S. Assistant District Attorney Carolyn Ferko told jurors this week that Dr. Schwarz sped patients through so that he could file more Medicaid claims, and he rewarded employees who helped in this effort with large bonuses.

Tony Canales, attorney for Dr. Schwarz, said all the procedures billed for were legal. "There is no evidence of willful intent to violate the law," he told jurors.

If found guilty, Dr. Schwarz could face up to 10 years in prison without parole and up to a $250,000 fine.

Irene Tsikitas